photography by Niki Litov / Getty Images
Vials and Syringe
Dr. Robert Belshe’s love of chemistry was sparked when he created a pretend laboratory in his basement—just a boy with a chemistry set. In college, he initially thought he wanted to pursue marine biology but ended up studying vaccine development. He later founded Saint Louis University’s Center for Vaccine Development, which has been responsible for various vaccine breakthroughs and has received more than $100 million in research funding. He’s also a professor emeritus in the Division of Infectious Diseases, Allergy, and Immunology. Belshe spoke with SLM from California, where he was recently honored as the recipient of the 2023 American College of Physicians James D. Bruce Memorial Award for Distinguished Contributions in Preventive Medicine.
How did you first get into science? I’ve always been interested in science since I got my first chemistry set in grade school and did experiments in my basement. Me and my friends were always tinkering with science in the basement and getting newsletters in the mail with science experiments for kids. When I went to William & Mary, I thought I would be a marine biologist. But during college, I was drawn back to chemistry more and more, and I wound up concentrating on physical chemistry.
What are some of the vaccine breakthroughs you’ve seen during your career? In my lifetime, we’ve seen tremendous success in vaccine development. We’ve seen bacterial vaccines that prevent bacterial meningitis in children, pneumonia vaccines that prevent pneumonia in children and adults, and new vaccines that prevent cervical cancer. It’s been a tremendous 30 years of advancements—and the most recent enormous success of COVID-19 vaccines.
What are some breakthroughs you’ve made in your work? What we do at the Center for Vaccine Development is pioneer new concepts and develop data that allows for the development of new vaccines. We did some of the early studies with many of the new bacterial vaccines, for example, high-dose influenza vaccines for older persons and intranasal vaccines for influenza… The best example from the last couple years—in addition to COVID-19 vaccines—has been the vaccine for smallpox. Sharon Frey at the Center for Vaccine Development led many of the vaccine studies that were done right after 9/11, when we were afraid that there was a shortage of smallpox vaccines. We were afraid that a biological agent like smallpox might be released by terrorists or in a situation of regional wars. And so we found that you could dilute the standard smallpox vaccine…and still get a very good response. With the most recent outbreak of monkeypox, which is now called “Mpox” and is closely related to smallpox, the immunity cross-reacts. Those dilution studies with some of the more modern smallpox vaccines held equally true, so there was a concern that we didn’t have enough vaccine to prevent Mpox, but it turns out that it could be diluted. Some of those early studies that we did with diluted vaccines supported that… The point is you never know what’s going to be important in science, including public health. What we do today lays the foundation for the eventual use of vaccines in one situation or another.
Cancer Care
AT ST. LUKE'S BISPECIFIC ANTIBODY IMMUNOTHERAPY OFFERS A NOVEL APPROACH TO TREAT BLOOD CANCERS.
With bispecific antibody immunotherapy, some physicians are hoping to change the face of cancer care. Dr. Mark J. Fesler (p. 80), a hematologic malignancy specialist with St. Luke’s and a board of trustees member for the Leukemia and Lymphoma Society’s Lower Plains chapter, is the principal investigator for two clinical research trials into the treatment. Compared to chemotherapy, Fesler says, bispecific antibody immunotherapy can involve fewer toxicities and less damage to host tissues in the body. Additionally, unlike CAR T-cell therapy, bispecific antibody immunotherapy can result in lower rates of such side effects as cytokine release and neurotoxicity. Fesler anticipates that the insights gained from this treatment could become applicable for other forms of cancer, which would mark a major step forward in cancer care. For now, he says, the therapy offers the potential to treat blood cancers with improved efficacy and fewer cumulative side effects. “Both the quality of life and life expectancy for blood cancer patients are expected to improve as a result of this exciting advance in the field,” Fesler says.
Getting National Institutes of Health–funded grants is becoming increasingly competitive. What’s been the key to your success? We developed a cadre of physician-scientists who were experts at conducting clinical trials. And the community supported our clinical trials. These volunteers were also pioneers. We communicated to the community the need for volunteers, and they turned out. Over the decades, thousands—if not tens of thousands—of people in St. Louis have participated in clinical trials. This is very difficult to do. There are a lot of hurdles to get from the concept to an idea of a new vaccine to the final answer of “yes, it works” or, “no, it doesn’t work.” Those things are very difficult to do and require a lot of regulatory oversight… We have these physicians to deliver the skills and conduct clinical trials in a regulated environment that produced quality data. That made us somewhat unique; we’re among a relatively small number of institutions that have that depth of investigators who can do that. SLU was great at helping support us by assuring all of the regulations could be followed and developing high-quality data. That helped tremendously. We’re always competing against top-level universities, but our track record helped attract funding. During the time I was at SLU, we attracted well over $100 million in research funding as grants or as contracts from the NIH. Seeing that funding continue to carry on big projects has been very gratifying.
What have been some of the greatest lessons you’ve learned during your career? You’ve got to be willing to pivot. SLU has a saying: “Without funding, there is no mission.” And that’s something one has to be prepared for: to change focus a little bit in science when you’re dependent on others for funding. Whatever you do, make sure you’re going to enjoy it because you’ll spend a lot of time thinking about it. To become an expert in something takes thousands of hours of study, and that’s a lot of years. Enjoy what you do, and then be flexible enough to change focus a bit to stay in something enjoyable.
